Nurses in the United States: Please do not sit this election out. Do your duty as an American citizen and as a nurse. Make informed decisions about candidates and issues and cast your ballot (just once, that is—don’t listen to our current president, silly man that he is, only vote once, whether it is by mail or in person or via e-mail for oversees folks). Voting is always important and is a sacred civic duty. This year, it is especially crucial for the health and future of our country. And do whatever you can to encourage and enable other people to vote, including your patients and your community members.
If you happen to be a nurse educator as I am, remember that you can and should provide course content on the importance of political knowledge and advocacy for nursing. It seems to be a common misperception among nurse educators that political content is somehow a no-no and that it can get them in trouble with their employers. Providing non-partisan information on being an informed voter is never a no-no. And, our nursing students need to be exposed to nursing faculty and other mentors who are politically engaged—including nurses who run for political office at the local, state, and national levels. A great non-partisan resource is the All In Campus Democracy Challenge. Check to see if your college/university has signed on to this challenge and what resources and activities you can tap into.
In just a few weeks, I will cast my ballot here in Seattle, King County, Washington. I am proud of our state and county for ensuring that our elections are safe and open to every eligible voter, no matter their race/ethnicity, country of origin, language, able-ness, and political affiliation. I am proud to be part of the grassroots Nurses for Biden-Harris group, working to promote information on the reasons why nurses should strongly consider voting for the Biden-Harris ticket: compassion, faith, resilience, empathy, kindness, humility, joy, respect, inclusion, and dignity. Those are the core values of Joe Biden and Kamala Harris. They also happen to be core values and part of the Nursing Code of Ethics of the American Nursing Association.
We are excited to announce a series of web discussions “Overdue Reckoning on Racism in Nursing” starting on September 12th, and every week through October 10th! This initiative is in part an outgrowth of our 2018 Nursing Activism Think Tank and inspired by recent spotlights on the killing of Black Americans by police, and the inequitable devastation for people of color caused by the COVID-19 pandemic.
Racism in nursing has persisted far too long, sustained in large part by our collective failure to acknowledge the contributions and experiences of nurses of color. The intention of each session is to bring the voices of BILNOC (Black, Indigenous, Latinx and other Nurses Of Color) to the center, to explore from that center the persistence of racism in nursing, and to inspire/form actions to finally reckon with racism in nursing.
Lucinda Canty, Christina Nyirati and I (Peggy Chinn) have teamed up…
Ibram Kendi writes, “We are surrounded by racial inequity, as visible as the law, as hidden as our private thoughts. The question for each of us is: What side of history will we stand on?” (How to Be an Antiracist, p. 22).
In preparing to teach population health nursing and health policy and politics again this coming academic year, I am working with the good folks at StoryCenter to develop media literacy content utilizing digital storytelling videos. And, since our University of Washington Health Sciences Common book will be Kendi’s How to Be and Antiracist (not to mention the current moment in terms of racism in our country), I plan to use digital storytelling focusing on racism and bias in nursing and health care.
Nurstory, working with StoryCenter, has some excellent digital storytelling videos by nurses across the country, including nurses with the Nurse Family Partnership. Dr. Raeanne Leblanc and her colleagues at University of Massachusetts, Amherst, completed a Nurstory project on social justice. My plan is to work with our students on the use and making of digital stories related to racism and bias. Since I believe that I should practice what I preach (or teach in this case), I recently made a digital storytelling video on my experience of racism in various aspects of nursing, including nurse education. Titled “Relics,” here it is:
My hometown of Richmond, Virginia is a city anchored to its past by bronze and marble Confederate shrines of memory. I was born in Retreat for the Sick Hospital, Richmond’s oldest hospital opened in 1877 by Civil War nurse Annabella Ravenscroft Jenkins. The hospital was around the corner from the towering memorial to Jefferson Davis—a memorial topped by Vindicatrix, the symbol of virtuous white womanhood—a woman literally on a marble pedestal.
My paternal great-great grandmother from a Georgia cotton and slave-owning plantation was a first cousin of Varina Davis, First Lady of the Confederate States of America. I was raised on Richmond’s eastern edge, on the relic-strewn Civil War land of Cold Harbor. I am a product of Virginia public schools: Battlefield Park Elementary School, Stonewall Jackson Middle School, and Lee-Davis High School. I went to high school with the son of the Grand Dragon of the Ku Klux Klan who threatened me with physical violence if I did not stop campaigning for Jimmy Carter. The high school’s song was the “Rebel Yell” and then, as now, it is called the “home of the Confederates.”
During my nursing education at the Medical College of Virginia in Richmond, I mostly cared for homeless and impoverished (and oftentimes imprisoned, shackled to their beds) African-American patients in the ‘old hospital,’ formerly the ‘Negro-only hospital.’ The new MCV hospital curled around the White House of the Confederacy like a lover. In nursing school, we were taught that the profound racial health disparities in our country were caused by inherent biological differences of African-Americans, rendering them more susceptible to disease. Therefore, it was implied, we could do nothing to change these health disparities. Racism and its health effects were never discussed.
Starting in 1986, as a newly-minted nurse practitioner, I ran a health care for the homeless clinic in the Richmond Street Center. My first HIV/AIDS patient was an African-American man who became so ill that I drove him to MCV Hospital where, after a protracted and painful month, he died. His hospital chart listed me as next of kin and I was asked to attend a hospital ethics meeting to decide whether to remove him from life support. I was not there when he died but I attended his graveside funeral in the Potters Field area in the city-owned Oakwood Cemetery. Even then, I was aware of the moral pitfalls of white supremacy masquerading as white savior.
For the past three decades, I have lived and worked in the younger and more progressive city of Seattle. It took this geographical cure, living away from and looking back at my upbringing in the American South to understand the insidious and caustic effects of the South’s sense of history and of place, including the rigid roles of race, class and gender. These insidious and caustic effects are on me as an individual, and on my family, community, and country.
But my smugness and sense of living in a morally superior region of our country has long since been tempered by experience. Deeply entrenched racism is not just a relic of the American South. It should not have taken the killing of George Floyd by a police officer in Minneapolis to have reminded us of that fact.
I teach public health at a school of nursing founded by Seattle public health nurses and stemming from their response to the 1918 influenza pandemic, a time eerily reminiscent of our current COVID-19 pandemic, including its disproportionate burden on communities of color. Elizabeth Soule, our school’s first dean and dubbed the “Mother of Nursing in the Pacific Northwest,” banned admission of African-American students until her retirement in 1950. My students have pointed out that several of our required medical-surgical nursing textbooks continue to erroneously perpetuate a biological basis of African-American health inequities. Our students of color continue to encounter white patients who refuse to be cared for by them. Our hospitals and our school continue to support these patients’ wishes, reinforcing institutional racism.
It heartens me to know that protestors tore down the Monument Avenue statue of my relative, Jefferson Davis, in early June. As of this writing, Vindicatrix remains high on her pedestal but the city plans to remove her and all other Lost Cause statues. This, and the activism of my nursing students, give me hope that there will be meaningful dismantling of the systemic racism running through our monuments, schools, healthcare institutions, and professions.
In this time of justifiable anger, protest, and civil unrest, let us not forget other ways that the rights of persons of color are being undermined in our country. DACA: Deferred Action for Childhood Arrivals is an Obama-era program that gives temporary legal status and work permits to undocumented immigrants who came to our country as children. The vast majority of DACA recipients are young people of color and many of them work as nurses and other essential workers. (see “Washington’s DACA recipients on the coronavirus frontline await Supreme Court ruling” Nina Shapiro, The Seattle Times, May 31, 2020)
The Trump administration, big on building walls and racial/ethnic/political divisions in our country, has been trying to dismantle DACA. The NAACP is a staunch supporter of DACA. The Supreme Court is set to rule on a major DACA case any day now. In fact, they were expected to release their ruling today but likely delayed it in case their ruling fuels further protests.
So proud of our University of Washington nursing students for using their talents and experiences to speak out on important health policy current event issues. This is just one of the student group digital storytelling health policy videos they produced for my spring quarter 2020 healthcare systems course. They consented to me sharing it. I will share additional health policy student-produced videos in future posts. This one is especially relevant to the current outcry across our country about racism, hate crimes, and police violence against black and brown people.
Since I have posted a summer reading challenge (with a health humanities/social justice focus) beginning in 2015, I continue the tradition this year. Please support your local independent bookstores because we need them to survive the COVID-19 pandemic. I miss being able to visit in person my favorite local indie Elliott Bay Book Company.
Thirteen books, left to right in the photograph above.
11. American Birds: A Literary Companion, edited by Andrew Rubenfeld and Terry Tempest Williams. Because watching birds in my backyard during the pandemic shelter-in-place spring have entertained and soothed me.
12. Brian Doyle’s One Long River of Song, a collection of essays. Because I miss the compassionate and lyrical voice of one of my favorite contemporary writers who died in 2017 from a brain tumor.
13. Louise Aronson’s Elderhood. Because I have heard good things about geriatrician and writer Aronson’s book. And because this is the summer I officially enter elderhood. And because as a society we suffer from extreme ageism as highlighted by our seeming indifference to the high death rates from COVID-19 among our elders. (see Aronson’s article “Ageism is making the pandemic worse” in The Atlantic, March 28, 2020.
Self-care is important but insufficient. Access to high quality, low-barrier, affordable, confidential, and non-stigmatizing mental health treatment for nurses is an absolute requirement under any circumstances. But especially now when what we are asking our nurses to do—and all nurses, not just ICU and emergency department nurses-—is emotionally taxing and traumatic at unprecedented levels. And now, during a time of a public mental health and substance use disorder crisis, as the American Public Health Association has declared. And states that continue to have antiquated and punitive state licensing laws for nurses and other healthcare providers, requiring providers to reveal any and all mental health treatment, those state laws need to be changed so that they aren’t an additional barrier to to mental health treatment. (see: “Why don’t doctors seek mental health treatment? They’ll be punished for it” Kayla Behbahani and Amber Thompson, Washington Post, May 11, 2020)
Happy 50th Earth Day. Happy what would have been my mother’s 97th birthday. Today, although stymied by the current coronavirus pandemic from going to hear Elizabeth Kolbert talk about her work on books such as The Sixth Extinction, I am grateful for all the wise women (and men, but especially the women) scientists and artists and writers and activists who have helped improve at least some aspects of environmental—planetary—health.
I was almost ten years old on the first Earth Day in 1970 and I remember quite vividly the day I saw my first bald eagle, soaring above a high mountain pass in West Virginia where my oldest sister lived. Bald eagles, of course, had been decimated by the use of DDT, the use of which was not banned in the US until 1972. Now, the bald eagle population has rebounded and they soar over my house here in Seattle almost every day. There is so much more work to be done, but for this, I am grateful.
One local wise woman who was an environmental and social activist and whose life and work I have been researching (and appreciating) is Hazel Wolf who died January 19, 2000 at 101 years of age. She worked on housing and health insurance earlier in her life (especially during the Great Depression) and then on environmental justice issues all the way up until the end of her life. She was a woman of action and an appreciator of life. She asked for a cookie right before she died. Here is something she said in an oral history interview with Susan Starbuck, author of Hazel Wolf: Fighting the Establishment:
“I look out my kitchen window. Every morning the pigeons, and sometimes crows, get on the wire across the street and just sit there. When I’ve been out camping, I’ve noticed that very early the birds will get someplace and sit, enjoying the morning. It’s quiet. They have to spend all the rest of the day finding food. So when they get up in the morning, they just relax and enjoy the sun. I don’t know what they’re thinking about. I, too, like to site, look at things. This is the side of animal life that Darwin overlooked. He didn’t understand that birds have souls.” (p. xv)
Where to begin? For one thing, I will begin by acknowledging that I still have a job, and I have a job that can be done from the “shelter in place” comfort of my own home here in Seattle. These are privileges that I am acutely aware that many others in my neighborhood, city, country, state, and world do not have. These are privileges that homeless people I work with do not have.
I will not complain about having to “pivot” (but oh how I loathe that over-used term right now!) and convert a new health politics/policy course from an in-person class format to completely online within a week’s time. I will not complain that the hastily-added Zoom feature on our course websites is already crashing and our spring quarter has not yet begun.
The course I designed and will be teaching starting next week is a required course for all pre-licensure nursing students in our newly revised curriculum that rolled out this past fall. I have a cohort of about 150 students, a mixture of traditional BSN students and accelerated BSN (ABSN) students–meaning they already have a degree and complete their nursing courses in one academic year. The ABSN students will soon graduate and enter the nursing workforce. Many of them, as well as the BSN students, are already working as nurse techs in hospitals and nursing homes. Since most of them live and work in the Seattle area—the site of our country’s first COVID-19 outbreak and known community spread and mounting death toll along with the insane shortage of basic protective gear like masks—they know first-hand two lessons included in my course syllabus: 1) US healthcare is characterized by excess and deprivation (rich people still getting tummy tucks and facelifts while COVID-19 patients die from lack hospital beds/staff/ventilators), and 2) rationing of healthcare is already a reality even before the COVID-19 pandemic reached the US.
Luckily, I had this same cohort of students last fall quarter in a community/population health course which we now lead with instead of including as an afterthought as most nursing schools still do. As part of that course, I had them complete the excellent (and free!) online training modules on disaster preparedness (include mental health/PTSD in first responders) from the Northwest Center for Public Health Practice. I also had them write a narrative policy paper based on Health Affair‘s “Narrative Matters” series of essays. Many of their papers were excellent and based on current event public health/health policy topics.
For the spring quarter health politics and policy course I will have them work in teams (virtually, of course) of ten students and write and produce 8-10 minute personal policy and advocacy storytelling videos based on current event topics (including the pandemic). These are based loosely on the StoryCenter/Nurstory series of videos, although all of theirs are single person-single story videos. (One of my favorites is “Pride and Prejudice” by Maud Low on reproductive rights.) I am excited to see what they come up with and will–with their permission–share/link to some of their final participatory/narrative policy videos at the end of the quarter.
In yet another surreal moment in the midst of numerous such moments during this time, I am struck with the fact that by writing/thinking about “the end of the quarter” I have the simultaneous realization that—assuming my students and I are still standing (or sitting, or lying) by then—we will all have been even more profoundly and personally touched by this pandemic.